Lack of family and social support as well as depressive symptoms are the main elements that impair the ability of patients to adopt healthy habits and practices. Nursing and medical professionals from the Cardiology Service of the Bellvitge University Hospital (HUB) and IDIBELL and the South Metropolitan Primary Care have conducted a study that may allow the use of psychosocial factors as predictors of self-care outcomes.
The prevalence of heart failure (HF) has been growing steadily in Western societies for years and is now estimated to affect between 1% and 2% of the population. The continuous improvement of therapeutic tools and treatments has led to an increase in the average survival rate of HF patients, which is over 60% at 5 years. After discharge, the ability of patients to adopt healthy habits and practices in their daily lives, ranging from diet to physical activity, becomes an essential component in improving their quality of life and reducing the risk of disease aggravation.
The study was carried out with up to 1,123 people with HF with the aim of identifying psychosocial factors associated with poorer self-care. A detailed assessment of the demographic, clinical and social parameters of each of these patients was carried out. “This has allowed us to identify both the lack of social and family support resources (for instance, the services of a caregiver) and the appearance of symptoms of depression as the main factors of abandonment of self-care.” states Esther Calero, nurse at the Cardiology Department of the Hospital de Bellvitge, IDIBELL researcher and one of the authors of the study.
The study has been published in the International Journal of Nursing Studies, the most relevant nursing journal worldwide.
Among the implications of the research, stands out the recommendation to complement the clinical assessment of the patient with another comprehensive psychosocial and socioeconomic assessment “in order to identify potential obstacles that may hinder optimal self-care,” stresses Esther Calero. Early assessments of this type would act as predictive elements and facilitate the design of specific actions for each case, “a process in which nursing plays a decisive role”, concludes Calero.
The process of self-care also involves voluntary patient education and knowledge of heart failure management. In this sense, the progressive worsening of self-care measures may be associated with another negative effect: the patient's inability to recognise the first symptoms of possible decompensation.
Another of the study's conclusions is that the highest levels of self-care in patients with HF are found among women. This fact is associated with the caregiving role women have traditionally played for children, partners, the elderly and dependent persons.
The study is part of the actions undertaken by the Territorial Programme of Integrated Care for Patients with Community Heart Failure of the Southern Metropolitan Territorial Management of the ICS. This programme, which has a shared leadership between the HUB and Primary Care, is coordinated by Dr. Josep Comin, head of the Cardiology Service of the hospital, and Coral Fernández, assistant to the South Metropolitan Primary Care Management, and is based on maintaining continuity of care between the hospital and primary care.
Reference article
The interaction between psychosocial and heart failure-related factors may partially explain limitations in self-efficacy in heart failure patients: Insights from a real cohort of 1,123 patients; E.Calero-Molina; P.Moliner; E. Hidalgo; L.Rosenfeld; J.M.Verdú-Rotellar;J.Verdú-Soriano; S.Yun; A.Garay; L.Alcoberro; S.Jiménez-Marrero; N. Jose; ECalvo; M.Ruiz; P.Garcimartin; A.Alcaide-Aldeano; C.Delso; L.Alcober, C.Enjuanes, J.Comin-Colet https://www.sciencedirect.com/science/article/abs/pii/S0020748922000621?via%3Dihub